Sunaina Rayamajhi
Farmersville,TX
Summary
Service-driven professional highly informed of all state and federal regulations pertaining to benefits for employees. Communicative Benefits Specialist offering outstanding customer service and data confidentiality skills.
Overview
5
5
years of professional experience
Work History
Benefits Specialist
Yeti Technologies
Irving, TX
02.2023 - Current
- Assisted employees with enrolling in benefit plans and explained plan options.
- Processed benefit enrollment forms, changes, and terminations.
- Researched and resolved employee inquiries regarding benefits programs.
- Reviewed eligibility for medical insurance coverage and other benefit plans.
- Maintained records of employee participation in various benefits programs.
- Generated reports on health care costs, retirement savings, and other related topics.
- Monitored compliance with federal and state regulations concerning employee benefits.
- Analyzed financial statements to ensure accuracy of reported information regarding employee benefits.
- Provided guidance on claims processing procedures to ensure timely payments.
- Developed documents outlining details about each available benefit program option.
- Coordinated benefits processing, including enrollments, terminations and claims.
- Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
- Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
- Collected and compiled HR data and statistics and made process improvement recommendations.
Benefit Verification Specialist
Vastika
Plano, TX
11.2021 - 02.2023
- Reviewed and verified health insurance benefits for patients prior to their scheduled appointments.
- Identified discrepancies in patient benefit information and resolved them with the insurance provider.
- Collaborated with medical staff to ensure accuracy of patient records and eligibility for services.
- Interpreted complex policy language from insurance providers to determine benefits coverage.
- Conducted research on new products offered by insurance companies and provided recommendations based on findings.
- Maintained accurate records of all verifications, including date of service, procedure codes, diagnosis codes.
- Assisted customers in understanding their benefits package and how it relates to their individual needs.
- Monitored changes in regulations related to healthcare benefits verification processes and procedures.
- Processed requests from physicians' offices for pre-authorization of tests or treatments.
- Conducted data entry into relevant systems regarding benefit verifications.
- Educated customers on the importance of staying up-to-date on their premiums and other costs associated with their policies.
- Worked closely with internal teams to ensure compliance with state and federal regulations governing healthcare benefits verification processes.
- Coordinated benefits processing, including enrollments, terminations and claims.
- Reviewed employee enrollments to verify accuracy, inputting information into company database.
- Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
- Produced detailed reports and data models to help clients pick optimal plans.
- Collected and compiled HR data and statistics and made process improvement recommendations.
- Performed in-depth investigations into personal backgrounds of applicants.
- Administered employee insurance, pension and savings plans, working with insurance brokers and plan carriers.
- Evaluated job positions to determine classification, exempt or non-exempt status and salary.
Accounts Receivable Clerk
wolff-terry
Plano, TX
11.2019 - 11.2021
- Responsible for entering customer payments into the accounting software system.
- Maintained accurate records of accounts receivable and payable transactions.
- Assisted in month-end closing activities such as preparing journal entries, reconciling accounts, and creating financial reports.
- Analyzed customer account information to identify discrepancies or trends in payment history.
- Processed invoices, credit memos, and other documents related to accounts receivable.
- Reconciled daily cash receipts with bank deposits.
- Managed collections activity including contacting customers regarding past due balances and resolving billing disputes.
- Investigated any discrepancies between invoices and purchase orders prior to processing payments.
- Reviewed all incoming payments for accuracy before posting them into the general ledger system.
- Sent copies of invoices and statements to customers to facilitate payment of outstanding invoices.
- Reached out to vendors and customers to resolve account problems.
- Calculated unpaid invoices to maintain updated receivables reports.
- Posted and verified entries to logs, spreadsheets or reports to update department records and accounting systems.
Payment Processing Specialist
Bank of America
Dallas, TX
01.2019 - 11.2021
- Reviewed customer payment information and ensured accuracy of data entry.
- Created daily, weekly, and monthly reports on payment processing activities.
- Resolved discrepancies between customer payments and company records.
- Investigated returned payments for errors or fraud.
- Processed incoming payments in an accurate and timely manner.
- Assisted customers with questions regarding billing statements and payment options.
- Maintained up-to-date knowledge of applicable laws, regulations, and policies related to payment processing operations.
- Conducted regular audits of internal processes to ensure compliance with established standards.
- Performed maintenance tasks on the payment processing system as needed.
- Generated invoices for customers based on their purchase history and current orders.
- Developed strategies to reduce manual effort associated with payment processing activities.
- Ensured all transactions are properly documented according to legal requirements.
- Identified opportunities for process improvement within the organization's payment systems.
- Drafted correspondence regarding late payments or disputed charges.
- Responded promptly to inquiries from external parties relating to payment issues.
- Verified patient insurance coverage, created financial plan according to treatment schedules for collections and communicated between patient and billing company regarding health insurance.
- Processed new customer forms to set up accounts in system.
- Activated contracts and set up installment billing plan to generate on-time payments.
- Received and recorded cash, checks and transfers.
- Reconciled computer reports with manually maintained ledgers.
- Prepared and processed payrolls.
- Calculated and produced checks for utilities, taxes and other operational payments.
Education
MBA - Accounting And Finance
Amberton University
Garland, TX01-2024
BBA - Accounting And Business Management
Strayer University
Washington, DC09-2019
Skills
- Client Counseling
- Open Enrollment Procedures
- Enrollment Procedures
- Enrollment Coordination
- Benefits Administration
- Financial Data Reviews
- Employee Benefits Practices
- Payroll Support
- Documentation And Reporting
- Written And Oral Communication
- Data Analysis
- Hr Understanding
- Recordkeeping
- Account Reconciliation
- Billing Cycle Management
Languages
English
Native/ Bilingual
Nepali
Native/ Bilingual
Hindi
Native/ Bilingual
Timeline
Benefits Specialist
Yeti Technologies
02.2023 - Current
Benefit Verification Specialist
Vastika
11.2021 - 02.2023
Accounts Receivable Clerk
wolff-terry
11.2019 - 11.2021
Payment Processing Specialist
Bank of America
01.2019 - 11.2021
MBA - Accounting And Finance
Amberton University
BBA - Accounting And Business Management
Strayer University
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